Southbridge Medical Advisory Council, INC.

Southbridge Medical Advisory Council, INC. was paid $366K by Medicaid between Jan 2018 and Nov 2024, across 4 billing codes. Its largest line is G0467, community health center visit, returning patient — 98% of everything it billed.

33Billing provider infoSOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC.
CLAYMONT, DE 19703

33aNPI1760874549assigned 03/03/2015

33bProvider typeFamily Medicine Physician

28Total paid$366K

24GClaims4,581

24DCodes billed4

24AFirst – last monthJan 2018 – Nov 2024

Compared with peers

Next to other Family Medicine Physician providers in Delaware

Rank by total paid#26 of 97

Median peer was paid$101K

This provider vs. median3.6×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	311	$601.92
2019	154	$16K
2020	17	$1K
2021	713	$50K
2022	1,067	$91K
2023	1,236	$148K
2024incomplete	1,083	$59K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
G0467	Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit	98%	2,487	1,811	$359K
T1015	A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive	1.5%	276	233	$5K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	<1%	1,072	772	$978.52
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	<1%	746	548	$333.52

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialSCOTT, NACHET (CEO)

Parent organizationSOUTHBRIDGE MEDICAL ADVISORY COUNCIL, INC.